Tweet This

A work requirement for Medicaid recipients would add to health plan administrative costs and therefore hit taxpayers, say health insurers that administer benefits for millions of poor Americans.

Medicaid Health Plans of America (MHPA), which represents insurers like
Aetna,
Centene,
Cigna and
UnitedHealth Group, came out in opposition Wednesday to the Republican-led American Health Care Act. In a letter to leaders in the House of Representatives, MHPA took issue with everything from block grants to the quick rollback of Medicaid benefits that would “create unmanageable problems for the most disadvantaged Americans and the plans that provide access to their care.”

A vote on the AHCA is expected Thursday in the U.S. House of Representatives following a week of intense lobbying by President Donald Trump and Republican leaders who made changes to win over conservative House members that would allow states to impose work requirements on certain Medicaid recipients.

But health plans say a work requirement would add to administrative costs and take away from patient care.

Most Americans on Medicaid want to work or are working. “Only 13% of adults covered by Medicaid’s expansion are able-bodied and not working, in school or seeking work,” the Health Affairs blog said earlier this month, citing the 2015 National Health Interview Survey in its report.

Health plans say it’s common for poor Americans to work periodically so kicking them off when they lose a job could potentially lead to poor health outcomes. And that, in turn, can lead to higher costs when medical care is not coordinated.

“If Medicaid enrollees are moved off and on the rolls as they lose and gain employment, this will adversely affect the continuity of care management that is a hallmark of Medicaid managed care,” MHPA’s Myers said.

Medicaid health plans have taken on a greater role in managing health benefits for poor Americans as states look for ways to save money by having private companies run their Medicaid programs. In addition, these plans have grown after 31 states and the District of Columbia agreed to expand Medicaid coverage under the Affordable Care Act.

The GOP House legislation would roll back the ACA’s Medicaid expansion and cause millions to lose coverage. The Congressional Budget Office said the AHCA would cause 24 million Americans to join the ranks of the uninsured by 2026.

Several groups, including the American Medical Association, American Hospital Association and the American Nurses Association are opposed to the AHCA because of the loss of health benefits and access to Americans. These groups see block grants as merely a way to cap Medicaid costs and cut benefits to poor Americans.

“A shift to a new financing model of any type must be done in a manner that affords the states time to make decisions about their programs and coverage and to clearly explain their goals to the plans that provide the access to care for 73% of the Medicaid population,” Myers said in a letter to House Speaker Paul Ryan and leaders in the House Representatives.

I've written about health care for three decades, starting from my native Iowa where I covered the presidential campaign bus rides of Bill and Hillary Clinton through the Hawkeye state talking health reform and the economy. I have covered the rise, fall and rise again of he...